“Clarence is a pleasant, relaxed, lean, muscular white male who shows
very good insight into his health and fitness.” W. Lynn McFarlin, MD
(April 25, 2018)

Thirty-Year Report
from the Cooper Clinic

With Reader Comments

Carol and I
flanked by Dave Prokop and Dr. Arnie Jensen during our first visit to the
Cooper Clinic in 1988.
Arnie made a trip to Albuquerque to persuade me to come for a
head-to-toe exam.
Dave wrote a feature article about it in Muscle & Fitness. Photo
by Justin Joseph

This is perhaps the most guarded or mixed report of my
many exams over the last 30 years. While earlier reports have been
almost uniformly positive, this one has a few chinks.

Good & Bad Without Statin

“His overall sense of health is improved since he stopped statin therapy
which was causing body aches, chills and rigors…,” Dr. McFarlin wrote.

That’s good, right?

The fly in the ointment is that my lipid profile has
gone from ideal—70s across the board for good and bad cholesterol
and triglycerides—to rather good.

“Today’s lab studies on daily omega-3 fish oils shows a recurrent
hyperlipidemia with LDL far above goal level at 154 but your HDL is
quite good at 77 and as a result, your lipid ratio remains quite healthy
at 3.2,” McFarlin wrote. (Chol/HDL ratio under 4.5
is considered good.)

If my earlier numbers hadn’t been so damn good, this would be considered
okay. “Acceptable,” at least.

As I’ve written here before, CT angiogram tests with IV contrast
have shown my coronary arteries to be "very large." While my coronary
calcium
level is high, there is practically no narrowing of my coronary
arteries. Dr. Ho who oversees the tests—and discussed the results with
me at length—said I’ve got practically nothing to worry about.

The problem is that my margin for error is up in the air without the
statin. I have
considerable wiggle room never the less. If the situation becomes dire there are
options, such as the new injectable—and unproven—statin that costs in
excess of $14k a year and isn’t covered by Medicare (unless you have a
heart attack).

Lifestyle Factors

What I still have going for me is healthy living. My relaxed blood pressure is
excellent (105/65) and my fasting blood sugar and A1C
show “no evidence of diabetic tendency.” Unlike many people my age, I
don’t have diabetes or hypertension—and I’m not overweight.

My Omega-3 level is very good at 9.7%. (Anything over 8% is considered
good.) The sardines I have with breakfast and fish oil cap with lunch
and dinner are doing the job.

Stress Test Results

My exercise stress test—using my own 10 minute interval routine on the
Airdyne—was normal “showing no evidence of ischemic heart disease.”
While my peak heart rate was a little disappointing at 155, the all-out
30s intervals were perhaps the best I’ve ever done. I was very pleased
with my effort. Doing my own routine freed me up to
go for broke. (No exhaustion hazard hanging over my head)

The bummer was that my heart rate peaked at 214 during the recovery
period. The saving grace is that the peak cleared in less than two
minutes—with “no symptoms of lightheadedness or chest pain.”

I didn't feel a thing, and would not
have known my heart was spiking had I not seen it on the monitor. I
looked away, because it made me uneasy. I didn’t know it cleared so
fast until I read it in Dr. McFarlin’s report.

My heart rate spikes are few and far between—and I don’t know they are
happening until I see it on my Fitbit. The peaks have never showed up on the
Airdyne at home.

Testosterone Up--Again

My testosterone is going “up” rather than down—at 788. The previous
test, at 666, was the highest up to that time.

Dropping the statin could be a factor.

The only other thing that’s new is going for
rankings every couple of weeks on the Concept 2 rower—at 100 meters and
one minute. After turning 80, I’ve been improving on the sprints almost
every time out. I really enjoy the challenge. See
http://www.cbass.com/age80ranking.html

Pulling all of this together makes me feel pretty sanguine about the
road ahead. Informed by Dr. McFarlin, Cooper Clinic testing, and my own
research and experience, healthy living is still paying big dividends.

My bet is that it will do the same for you. Nothing beats self-help.

Readers Comment and Clarence Responds

Psychologist
Fears "Too Much Health"

Hi Clarence:

Congrats on your latest Cooper Clinic
results. Amazingly positive. I'm going to take issue with your
mention of "a few chinks." I see no "chinks," although if you do
enough tests on anyone (at any age) you'll always find
"something" you could call less than ideal.

I've been meaning to write you a note
since I read your The Healing Self piece. I'm a psychologist, so
I'm well aware of the massive insights being made into how the
mind impacts the body. The effect of stress and depression on
the adrenal gland (on cortisol –– hence inflammation –– and
adrenaline and norepinephrine) is long established. I often ask
people whether chronic stress, for example, is really that
different to taking a stimulant drug every day? No one would
argue that using drugs daily is likely to be harmful, but is it
that different if you're body is manufacturing the drug itself
in response to psychological upset?

With that said, here's another thing to
think about. While my approach to diet and exercise is very
close indeed to yours (based on yours in fact) I see
emotional/psychological risks. For many people there's only a
narrow line between healthy routines (uniform eating, movement,
exercise) and the sort of ritualistic behavior that we see all
the time in obsessional eating or exercise disorders. When
routine becomes ritual it can cause tremendous psychological
distress. Ritual can be a prison. The sufferer is no long free
to really live –– rather the body, or so-called "health," become
a barrier to experiencing the world.

I'll be honest with you (I'm not
proud for that!) and say that at times my own eating and
exercise has begun to feel ritualistic. In the short-term,
routine feels calming, safe, but that's a false friend if
eventually the routine begins to impose rules that circumscribe
living. To guard against this, I've long been forcing myself to
break routine semi-regularly. I might not allow myself to do a
certain amount of walking every day (or a certain number of
steps). Beyond that I both eat out regularly and try do so
WITHOUT thinking about calories (or about the exercise I might
do to compensate for calories!).

Anyway, something to think about. It's a
balance thing. Too much "health" might be mentally and as such
also physically "unhealthy." The best is the enemy of the good.

Good
points. No need to eat anything you don't like or exercise you
don't enjoy. So many options for every one. The
basic message of my book Take Charge.

Thanks
for taking time to pass on your insightful thoughts on healthy
living.

Clarence

Doctor
Offers Encouragement

Hi Clarence,

Going off statins at this point may be a good thing; the actual risk of specific blood profiles, especially in highly
active, healthy eaters such as yourself is controversial and evolving. You may well live 30 plus years in good health.
I have numerous patients over 100 without dementia, who are moderately
active and they never did anything for their health other than not
smoke much. People
are living longer and we do not know a lot about long term statin
effects, cholesterol rebound effects etc.

The Blue Zone and associated data (i.e. Bama, China etc.)
is pretty compelling that aging while inevitable, is not a nightmare in
every culture.

Lastly,
the LDL level thing is pretty much in flux. You
will probably outlive your doctors by at least 10 years!

Best wishes,
Wade Smith, MD

Heart Rate Monitor Invaluable
During Intervals

Hey
Clarence:

Thanks for sharing your 30 year health report. It’s good to hear you are
doing everything in your power to stay on top with your health and
fitness goals. I was interested to learn how your heart rate peaked to
214 after your intervals. Even though you felt fine, that’s where it’s
invaluable to have a heart rate monitor to see what’s going on. From now
on I’m going to wear one during my interval training instead of relying
on perceived exertion. Good to hear you are still fired up with the
concept 2 rowing sprints. There are a few guys in your age group that
are really close which makes for great racing. Last time I looked I was
in about 8th or 9th in the 50-59 age group (307m for the minute, light
weights). I’ll have to put this on hold for a while as I have just had
shoulder surgery. During the surgery they noticed I had inverted T waves
on the ECG which could be from being really dehydrated before the
surgery. I’ve done hard intervals on the bike since and everything looks
and feels normal. Might get it checked out just to be on the safe side.

All the best!

Andrew

Hi Andrew:

Glad you found my report of interest. Thanks for letting
me know.

Haven't had a heart rate spike for some time and hoping
the problem is behind me. Workout that caused the spike in the past are
showing nothing unusual on the Fitbit--including the same interval
routine on the Airdyne.

I've been including more uphill stretches in my weekday
walks and believe this may be helping. Got to be careful not to turn
recovery walking into Black Holes. But don't believe I've gone over the
line so far.

Good luck with your shoulder and congrats on 307 meters
in one minute row. I know how hard each meter comes.

Good training and thanks again.

Clarence

More on Statin Side Effects

Clarence,

Your June 1
Update on
Thirty-Year Report from the Cooper Clinic is
an interesting article. In the article it states that the statin
therapy was causingbody
aches, chills and rigors.
What I am curious to know is how long after you started statin therapy
did these side effects show up? and how long did it take you to realize
that the statin therapy was causing these side effects?

Sincerely,

Jason

Hi
Jason:

I'd been taking the statin for a long time, almost 20 years.

Took better part of a year to decide statin was causing problems. We
stopped statin for a time and then tried other statins. We did
this several times. Each time the symptoms stopped when we stopped stain
and started again when started another statin.

I didn't want to believe that the stain was causing problems after
working so well for many years.

If you have more questions about statins, please talk to your doctor or
cardiologist. Lots of things involved and varies from person to person.
My example may have no relationship whatsoever to you.

Keep in mind that I am not a doctor and not qualified to discuss any
case but my own.

Clarence

More Detailed Lipid Profile?

Hello Mr.
Bass,

Been following
your site for quite a while now - love the info and evidence-based
thinking.

In reading the
post regarding the thirty-year report, I was wondering if the clinic has
ever suggested having a more detailed lipid profile. It would be
interesting to know the LDL particle size and particle count as well as
more detail for HDL sub-fractions. The info could be enlightening.

Again, thanks
for the great postings.

Jim

Thanks, Jim. Appreciate your positive comments.

Cooper has their own lab and I'm not privy to discussions on what is
covered. I will tell you that it goes on for many pages, covering much
more than mentioned in my report.

My sense is that they are conservative and not inclined to include
untested markers. If necessary they refer to specialists, where the
tests you mention are more likely to be monitored.

They pay more attention to lifestyle and fitness that other clinics.
Patients pay upfront and are more motivated than most.

Thanks again for taking time to comment.

Clarence

Lab Results Helpful - Questions

Clarence, thank you so much for sharing the results of your physical and
labs.

This is so helpful compared to the usual anecdotal info!

A few questions: Has your LDL been up your last several lab draws? What
explanation do your Drs. Surmise?

You discussed that your heart rate peaked at 155 during your stress
test. Then you discussed that your heart rate peaked over 200. Is this a
new problem with your heart that is being followed? I was confused
because earlier you said (disappointed) with 155. At age 59 I rarely see
my hr hit 170 running sprints, so I don’t think my ticker goes any
faster-and you said 200+!

Thanks for all you do,

David

Hi David:

Glad you enjoyed CC report.

Docs have no explanation for LDL; probably genetics.

My high HDL and other good numbers help reduce concern. Doing everything
possible short of taking statin.

CAT in a year or so will show if my coronary arteries are staying wide
open. Optimistic that this will be the case.

Peaks in HR rate during recovery are a concern; no explanation. Happy to
report that no repeat since coming back from CC. Only change is more
uphill walking during week. Fingers crossed.

Thanks for writing.

Clarence

Successful Journey

Hi Clarence,

I've been coming to
your site for many years to read the new information you post on
aging and exercising.

I first went to your office/gym 25 years ago to get a posing suit
for a AAU competition. I was 36 years old and in MASTERS already.
When I was really into bodybuilding I was around 195lbs at 5'9". I
quickly learned this was not good as my blood pressure continued to
rise and my cholesterol rose with it. I could start taking beta
blockers or lose weight and concentrate more on aerobics. I started
to ride bikes, road and mountain, and left the gym altogether. As my
weight came down so did the BP but my cholesterol didn't. I
concentrated more on my diet and finally went full vegan 2 years
ago. I use Forks Over Knives, Engine Two Diet, and Dr. Michael
Greger (NutritionFacts.org). My stats now are weight 172 TChol 136,
Triglyceride 71, HDL 49, LDL 73. Dropping all meat and dairy did the
trick. Might help you get over the last hump with your LDL.

I also, after reading your love of the Concept 2 and HIIT training,
started CrossFit 2.5 years ago. 1 hour in the mornings and
still riding in some evenings. I routinely work out with a 73 year
old and we compete in the open competitions once a year. The "box,"
as it's called, has many types of competitions for all ages during
the year. Scaled appropriately for seniors, I placed 4th and the 73
year old placed 2nd in NM. There are 80 year old competitors doing
what 60 year olds do. The reason I mention it is because of your
love of competition and willingness to try new things.

So what about it. Join a box and we'll see ya at next year’s games.

Thanks for all the great information through the years. I still
count you as the first nutrition and health expert. Love eating a
peanut butter sandwich learned from your diet recommendation in
Ripped.